Professor Emery is an Arthritis Research Campaign Professor in Rheumatology.
Article first published online: 5 FEB 2002
Copyright © 2002 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 46, Issue 2, pages 489–493, February 2002
How to Cite
McGonagle, D., Marzo-Ortega, H., O'Connor, P., Gibbon, W., Pease, C., Reece, R. and Emery, P. (2002), The role of biomechanical factors and HLA-B27 in magnetic resonance imaging-determined bone changes in plantar fascia enthesopathy . Arthritis & Rheumatism, 46: 489–493. doi: 10.1002/art.10125
Drs. McGonagle and Marzo-Ortega contributed equally to this work.
- Issue published online: 5 FEB 2002
- Article first published online: 5 FEB 2002
- Manuscript Accepted: 24 SEP 2001
- Manuscript Received: 21 MAY 2001
- Medical Research Council
- Arthritis Research Campaign
To study the role of biomechanical factors and HLA-B27 in plantar fasciitis.
T1-weighted and T2 spectral presaturation with inversion recovery (fat suppressed) magnetic resonance imaging (MRI) sequences of the plantar fascia insertion and adjacent bone were performed on 28 patients with plantar fasciitis; 17 had spondylarthropathy (SpA)-associated disease, and 11 had mechanically induced disease. The relationship between the degree of bone edema, scored on a semiquantitative scale (from absent to severe), and the patient's HLA-B27 status was determined.
On MRI, edema within the soft tissue at the enthesis was evident in both groups. Bone edema in the adjacent calcaneum was evident in 64.7% (11 of 17) of patients with SpA and in 45% (5 of 11) of those with mechanically induced disease (P = 0.441). HLA-B27 was identified in 9 (53%) of the patients with SpA but in none (0%) of those with mechanically induced disease. All 6 of the SpA patients with extensive bone edema but none of the 5 SpA patients with mild bone edema were HLA-B27 positive (P = 0.002).
The association of HLA-B27 with bone pathology in early enthesitis may have implications for a better understanding of the pathogenesis of SpA.